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Query: UMLS:C0017168 (gastroesophageal reflux disease)
 11,783 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The heterogeneous group of proteinases known as pepsinogens are synthesized, stored, and upon appropriate stimulation released from gastric mucosal chief cells. Under the acidic conditions of the lumen of the stomach, the proenzymes, pepsinogens, are converted to "pepsin", which plays an important physiologic role as a digestive enzyme. The potential roles for pepsin in upper gastrointestinal diseases such as gastric or duodenal ulcer and gastroesophageal reflux disease along with the recent development of in vitro gastric gland and isolated chief cell preparations have renewed interest in the study of the control of pepsinogen synthesis and secretion. In this article the authors briefly summarize current knowledge of the biology of pepsinogens and emphasize more recent findings concerning the control of the chief cell, which is related to the synthesis and secretion of pepsinogens in vitro.
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PMID:Control of pepsinogen synthesis and secretion. 218 30

The gastric acid secretion was evaluated by serum pepsinogen I/II ratio and serum Helicobacter pylori IgG antibody titer in gastroesophageal reflux disease(GERD) patient. GERD patients was 81 patients. Los-Angeles classification (LA)O, so called endoscopy negative reflux disease, was 6 patients, and LA-O-B patients was 68 patients. Helicobacter pylori infection ratio in GERD patients was 50.6%(41/81 patients). Pepsinogen I/II ratio in Helicobacter pylori positive GERD patients was no significant different from Helicobacter pylori negative GERD patients. We concluded that the gastric acid secretion in GERD patients was normal secretion.
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PMID:[Gastric acid secretion in gastroesophageal reflex disease]. 1100 5

The purpose of this study was to describe the clinical analysis of endoscopy negative gastroesophageal reflux disease (EN-GERD) in the elderly. 35 elderly patients of both sexes, 60 years or older with EN-GERD, 33 elderly patients with reflux esophagitis and 41 elderly patients as control group were included in this study. All patients witnessed verbal informed consent to participate in the study. EN-GERD was defined as the patients with normal endoscopy despite of heartburn as their chief complaint and who were completely relieved with heartburn after one-week omeprazole treatment. Helicobacter pylori infection between EN-GERD, reflux esophagitis and control were 37.1%, 24.2% and 56.1%, respectively. The gastric mucosal atrophy under endoscopic findings and the serum pepsinogen I, II ratio in EN-GERD had no significant differences with control. A hiatus hernia with EN-GERD was diagnosed 37.1%, which was lower significantly than 87.9% with reflux esophagitis. The motility of the stomach using the acetaminophen method was the same in patients with EN-GERD, reflux esophagitis and control. The anxiety score of the Hospital Anxiety and Depression Scale was significantly higher in the patients with EN-GERD than in those with reflux esophagitis and control. On the other hand, the severity of reflux symptoms in the patients with EN-GERD was similar as those with reflux esophagitis. We concluded that general anxiety plays an important role in the severity of the reflux symptoms in the patients with EN-GERD. As such symptoms in EN-GERD significantly impair the quality of life, further studies of patients with EN-GERD are greatly needed.
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PMID:[Clinical analysis of endoscopy negative gastroesophageal reflux disease in the elderly]. 1269 71

We attempted to clarify the pathogenesis of gastric inflammation in the cardia. Eighty Japanese participated in this study. Biopsy specimens of the gastric antrum, corpus, and cardia (1 cm from the squamocolumnar junction) were obtained, and histological gastritis was evaluated. Cardiac inflammation was also evaluated using magnifying gastroscopy. We examined Helicobacter pylori infection, gastric juice pH/bile acid (BA), serum pepsinogen and gastrin levels, gastroesophageal reflux disease (GERD), and habitual smoking and assessed the relations between these factors and cardiac inflammation. The prevalence of H. pylori infection was statistically higher in patients with cardiac inflammation than in those without inflammation (P < 0.05). The relationship was also demonstrated by magnifying gastroscopy. Cardiac inflammation was linked to low acid output but not linked to the BA concentration or habitual smoking. Cardiac inflammation was more pronounced in patients without GERD. These results suggest that H. pylori is a major risk factor for cardiac inflammation in the Japanese.
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PMID:Helicobacter pylori infection is the major risk factor for gastric inflammation in the cardia. 1660 36

GastroPanel (Biohit, Helsinki, Finland) is a serum test kit that measures Helicobacter pylori antibodies (HPABs) and pepsinogens I and II and gastrin 17, which reflect the degree of atrophic gastritis. We assessed whether GastroPanel can replace endoscopic biopsies in the diagnostics of H. pylori in children and whether the H. pylori-infected children show markers for atrophic gastritis. Eighty children (median age, 6.8 years; range, 0.6-18.7 years) underwent gastroscopy for H. pylori-related abdominal complaints (n = 40), surveillance after surgery for gastrointestinal tract malformations (n = 20), gastroesophageal reflux (GER) (n = 10), and miscellaneous diseases (n = 10). Gastric biopsies and a serum sample were obtained from all 80 children. HPAB levels of 38 and 15 IU were tested as cutoff values for H. pylori gastritis. The biopsies showed H. pylori-positive gastritis in 30 children, 9 had gastritis not associated with H. pylori, and 41 had normal biopsies. Atrophic gastritis was not found. The sensitivity and specificity of HPAB for H. pylori were 47% and 98% (cutoff, 38 IU), and 73% and 85% (cutoff, 15 IU), respectively. The assays of pepsinogens and gastrin did not improve sensitivity. None of the markers of pepsinogen (PG) I, PGII, and gastrin 17 (G17) indicated atrophic gastritis. GastroPanel is too insensitive for H. pylori screening and does not replace endoscopy. Markers indicative of atrophic gastritis were negative in all children with H. pylori gastritis.
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PMID:Is GastroPanel serum assay useful in the diagnosis of Helicobacter pylori infection and associated gastritis in children? 1694 82

The authors describe a current approach to the laboratory diagnosis of chronic gastritis, by using the plates of serological tests: pepsinogen I (PG-I), gastrin 17, and antibodies to Helicobacter pylori (HP). These tests and a questionnaire were used to examine 168 persons aged 45-70 years, who were a random population sample. Almost a fourth of the adult population was observed to have pronounced gastric mucosal atrophic changes, which might be associated with the high prevalence of HP infection. The concentration of PG-I is high in the persons infected with HP, its cytotoxic strains in particular, its elevated level servers as a valid marker of peptic ulcer disease and gastroesophageal reflux.
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PMID:[Noninvasive diagnosis of chronic atrophic gastritis by serology]. 1822 90

Achalasia surgical treatment alters the esophagogastric junction anatomy (cardiomyotomy plus fundoplication or esophagectomy and gastric pull-up), thus favoring a certain degree of gastroesophageal reflux. Gastric secretory and hormonal functioning is not completely known in chagasic patients. The aim of this study was to evaluate the gastric secretory and hormonal response in patients with end-stage chagasic achalasia compared with normal subjects. Gastric secretion and hormonal response were assessed by estimation of gastric acid secretion (GAS) in basal condition and after pentagastrin stimulation, basal serum gastrin, and serum pepsinogen (SP) in basal condition and after betazole hydrochloride (Histalog; Eli Lilly and Company, Indianapolis, IN, USA) stimulation in 27 patients with chagasic achalasia. The results were then compared with those of 24 normal subjects. In the chagasic group, the mean basal and stimulated GAS were significantly lower than in the control group (basal: 1.277 vs. 3.13, P = 0.002; stimulated: 15.9 vs. 35.8, P = 0.0001). Chagasic patients' SG levels showed a significantly higher basal value than the control group (83.3 vs. 36.8, P = 0.0001). There was a significant increase of SP after stimulation compared with the basal levels in both chagasic and control groups. Although the chagasic patients' SP values were higher than the controls, this difference was not statistically significant, either in basal and stimulated conditions (basal: 122.0 vs. 108.9, stimulated 120 min: 177.1 vs. 158.9). In patients with chronic Chagas' disease (ChD), although autonomic denervation does not suppress the strength of the gastric mucosal cells' secretory response to stimulation, it reduces GAS (parietal cell) without, however, affecting SP production (chief cells). On the other hand, the gastrin-producing cells have continuously been stimulated by low GAS.
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PMID:Gastric secretory and hormonal patterns in end-stage chagasic achalasia. 1930 18

Gastroesophageal reflux disease is mediated principally by acid. Today, we recognise reflux reaches beyond the esophagus, where pepsin, not acid, causes damage. Extraesophageal reflux occurs both as liquid and probably aerosol, the latter with a further reach. Pepsin is stable up to pH 7 and regains activity after reacidification. The enzyme adheres to laryngeal cells, depletes its defences, and causes further damage internally after its endocytosis. Extraesophageal reflux can today be detected by recognising pharyngeal acidification using a miniaturised pH probe and by the identification of pepsin in saliva and in exhaled breath condensate by a rapid, sensitive, and specific immunoassay. Proton pump inhibitors do not help the majority with extraesophageal reflux but specifically formulated alginates, which sieve pepsin, give benefit. These new insights may lead to the development of novel drugs that dramatically reduce pepsinogen secretion, block the effects of adherent pepsin, and give corresponding clinical benefit."For now we see through a glass, darkly."-First epistle, Chapter 13, Corinthians.
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PMID:Reflux revisited: advancing the role of pepsin. 2224 22

Gastroesophageal reflux disease (GERD) is widely associated with asthma, chronic cough, and laryngitis. Many studies have focused on acidic reflux; however, acid is just one of many factors that can cause pulmonary injury. The discrepancy between the high frequency of GERD in asthmatic patients and the ineffective reflux therapy outcomes in these patients suggests that GERD may cause injury through other mechanisms, such as pepsinogen, pepsin, bile salts, or other components of reflux materials, instead of the acid. Research using appropriate and innovative methodologies to investigate these potential inflammatory agents in patients with GERD is required to determine the underlying factors associated with pulmonary disorders in these patients.
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PMID:Extra-esophageal manifestations of gastroesophageal reflux disease: controversies between epidemiology and clicnic. 2316 70

We studied level of pepsinogen I and II in blood serum in 50 patients with erosive form of gastroesophageal reflux disease. Increasing concentrations of pepsinogen in 2.1 times and increasing the ratio of pepsinogen I to pepsinogen II in 32% of patients was detected. Which was associated with a higher degree gradation of erosive lesions of the esophagus and acid reflux prevalence with 2.0-2.99 pH range. Higher concentrations of pepsinogen II in serum was diagnosed in 20% of patients, and the results of daily pH monitoring in lower part of esophagus have been registered in them as acidic and alkaline refluxes.
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PMID:[Level of pepsinogen in patients with gastroesophageal reflux disease]. 2579 69


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